“Gender Reassignment” Surgery and the Perils of Hating the Body

On October 13, 2026, a new rule from the Centers for Medicare & Medicaid Services (CMS) took effect. It prohibits the use of federal Medicaid and Children’s Health Insurance Program (CHIP) funds for what CMS terms “sex-rejecting procedures” for minors. This mainly includes primarily puberty blockers, cross-sex hormone therapy, and related surgeries for those under 18 (Medicaid) or under 19 (CHIP). (Vitally, it does not affect mental health services.)

The new rule originated with the Trump administration. It began with an executive order issued by President Donald J. Trump in January 2025 that directed federal health agencies to restrict medical interventions for gender dysphoria in children. To support the decision, CMS has pointed to reviews of scientific studies that found that evidence for the benefits of such measures in children is weak or of very low quality. At the same time, these studies showed that potential harms – such as effects on fertility, bone health, and sexual function – were far better established.